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General NPI Number Information
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NPI Number | 1598973810
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Entity Type | Organization
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Legal Business Name | FERNANDO MUNGUIA DDS, INC
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 1060 W FOOTHILL BLVD
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City | UPLAND
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State | CA
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Zip | 91786-3730
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Country | US
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Telephone | 909-373-4600
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Fax | 909-373-4900
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Provider Business Mailing Address
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Address Line | 1060 W FOOTHILL BLVD
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City | UPLAND
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State | CA
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Zip | 91786-3730
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Country | US
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Telephone | 909-373-4600
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Fax | 909-373-4900
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Authorized Official
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Title or Position | PRESIDENT
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Name | FERNANDO M MUNGUIA
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Credential | DDS
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Telephone | 909-373-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 42578
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License Number State | CA
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